RCTs examining the efficacy of bupropion in adult ADHD frequently reported no statistically significant differences between bupropion and placebo; however, studies were hampered by small sample sizes. Meta-analyses suggest that bupropion treatment results in greater reductions in ADHD symptoms compared with no treatment; however, bupropion appears to be less effective than short-acting stimulants. Observational studies of patients presenting to poison control centres reported that seizure was frequently observed among patients with bupropion overdose; death was infrequent, and neurological sequalae were not reported, although this data did not appear to be sought. The incidence of seizure appears to be dose-related. Case reports indicated that seizure has been observed after nasal insufflation of small numbers of crushed tablets. Other than several case-reports, there is little harms information specific to recreational use of bupropion; the intentions behind the bupropion ingestions that led to inclusion in studies conducted with poison control centre data were often unclear. Thus the extent of bupropion toxicity secondary to inappropriate use, and recreational use specifically, remains unknown.